發(fā)布時間：2018-08-01 14:40

【摘要】：目的:采用Meta分析的方法系統(tǒng)評價胃食管反流病和喉鱗狀細胞癌的關系,為喉鱗狀細胞癌的預防和治療提供更好的科學依據(jù)。方法:全面檢索PubMed、Embase、Web of Knowledge、CNKI、萬方、維普和CBM數(shù)據(jù)庫。制定納入排除標準對文獻進行篩選,并采用Newcastle-Ottawa Scale(NOS)標準對納入文獻進行質(zhì)量評價。使用SAS 9.2統(tǒng)計學軟件對數(shù)據(jù)進行χ2檢驗和Fisher確切概率法計算P值,用Stata 10統(tǒng)計軟件進行Meta分析。根據(jù)異質(zhì)性檢驗的結(jié)果選擇模型合并各研究的OR值,并對合并后的結(jié)果進行發(fā)表偏倚評價和敏感性分析。結(jié)果:本研究共納入9篇文獻,包括32 348例喉癌患者和86 694名非喉癌患者。胃食管反流病在兩組人群中的患病率分別為21.0%和11.0%。納入的各文獻質(zhì)量均較高。合并后的OR值為2.01(95%CI:1.35~2.99),P0.001。漏斗圖和Egger檢驗均未發(fā)現(xiàn)明顯的發(fā)表偏倚。亞組分析顯示,胃食管反流病與喉癌的關聯(lián)僅見于美國人群,合并后的OR值為1.71(95%CI:1.06~2.76),P0.05。研究設計時對相關混雜因素進行匹配的亞組合并后的OR值略低于未匹配亞組。剔除兩個大樣本研究資料后,本研究結(jié)論不受影響。敏感分析結(jié)果顯示,本研究結(jié)論穩(wěn)定。結(jié)論:胃食管反流病與喉鱗狀細胞癌的發(fā)生相關。
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux disease (GERD) and laryngeal squamous cell carcinoma (LSCC) by Meta analysis. Methods: a comprehensive search of the PubMedus Embase Web of knowledge CBM, Wanfang, Wiper and CBM databases was carried out. The inclusion exclusion criteria were established to screen the literature and the Newcastle-Ottawa Scale (NOS) criteria were used to evaluate the quality of the included documents. 蠂 2 test and Fisher exact probability method were used to calculate P value by SAS 9.2 statistical software, and Meta analysis was performed by Stata 10 software. According to the results of heterogeneity test, the OR values of each study were selected, and the published bias evaluation and sensitivity analysis of the combined results were carried out. Results: this study included 9 articles, including 32 348 laryngeal cancer patients and 86 694 non-laryngeal cancer patients. The prevalence of gastroesophageal reflux disease in the two groups was 21.0% and 11.0%, respectively. The quality of the literature included was higher. The combined OR value was 2.01 (95%CI:1.35~2.99) P 0.001. Neither funnel graph nor Egger test showed any obvious bias of publication. Subgroup analysis showed that the association between gastroesophageal reflux disease and laryngeal cancer was only found in American population, and the OR value after the combination was 1. 71 (95%CI:1.06~2.76) P 0. 05. The OR value of the subgroup with matching the relevant confounding factors was slightly lower than that of the unmatched subgroup. After two large samples were excluded, the conclusion of this study was not affected. The results of sensitivity analysis show that the conclusion of this study is stable. Conclusion: gastroesophageal reflux disease is associated with laryngeal squamous cell carcinoma.
【作者單位】： 中國醫(yī)科大學流行病學教研室·遼寧省高校腫瘤病因與預防重點實驗室;中國醫(yī)科大學循證醫(yī)學中心;中國醫(yī)科大學附屬盛京醫(yī)院臨床流行病學教研室;
【分類號】：R739.65

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